Scoping review of remote rehabilitation (telerehabilitation) services to support people with vision impairment

Abstract

Objective: Telerehabilitation for individuals with vision impairment aims to maintain maximum physical and/or psychological functioning through remote service delivery. This review aims to describe the type of telerehabilitation services available to people with vision impairment and summarise evidence on health-related outcomes, well-being and cost-effectiveness.

Design: Scoping review.

Data sources: CINAHL Plus, MEDLINE, PsycARTICLES, PsychINFO, Embase, PubMed, HMIC and Ovid Emcare were searched, without date restrictions up to 24 May 2021. Charity and government websites, conference proceedings and clinical trial databases were also examined.

Eligibility criteria: Eligible studies evaluated benefits of telerehabilitation services for adults with vision impairment. Studies were excluded if they were not available in English, or focused on distance learning of visually impaired students.

Data extraction and synthesis: Two independent reviewers screened articles and extracted data. A risk of bias analysis was performed.

Outcome measures: Measures of benefit included performance-based assessment, patient-reported outcomes and cost-effectiveness.

Results: Of 4472 articles, 10 eligible studies were included. Outcomes addressed patient satisfaction (n=4;33.3%), quality-of-life, activities of daily living and well-being (n=4;33.3%), objective visual function (n=2;16.6%) and knowledge relating to ocular symptoms (n=1;8.3%). Two studies addressed multiple outcomes. Cost-effectiveness was addressed in one article (8.3%). Patients were generally satisfied with their experiences, which had a range of positive benefits on functional and quality-of-life outcomes in areas relating to daily activities (eg, reading, making phone calls). Telerehabilitation allowed patients to undertake vision optimisation training to prevent vision deterioration. Grey literature indicated that there are no completed clinical trials relating to low vision telerehabilitation. Charity services had implemented digital skills training to help beneficiaries communicate remotely.

Conclusion: While acceptability of telerehabilitation was mostly high, limited real-world data are available which raises questions around the long-term desirability of this approach. Further trials are needed to evaluate telerehabilitation using a robust set of outcome measures.

Prospero registration number: CRD42021254825.

Keywords: ophthalmology; quality in health care; rehabilitation medicine.

Figure 1

PRISMA diagram showing study selection process. PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses; VI, vision impairment.